In this episode, Sam Ashoo, MD interviews Kyle Howarth, MD and Joby Thoppil, MD, PhD – two of the authors of the May, 2022 EMP article on Cellulitis and Skin and Soft Tissue Infections. Listen to the discussion to hear more about the emergency department management of cellulitis and necrotizing skin infections.

Episode 69 – Emergency Department Management of Cellulitis and Other Skin and Soft-Tissue Infections (https://www.ebmedicine.net/topics/infectious-disease/emergency-medicine-skin)

EMplify – May 2022

Episode Outline:

1. Why cellulitis/skin infections?

2. Terminology

Erysipelas vs cellulitis vs fasciitis
Purulent cellulitis

3. Most common pathogens

4. Special situations

5. Necrotizing infection classification system – is this helpful in the ED, and if so, why?

6. Differential – unilateral vs bilateral presentation

7. Prehospital care

8. ED evaluation

History – what should we be asking?
Examination: SSTI vs NSTI

9. Diagnostics

POCUS: “cobblestoning” and fluid collection
Xray: subcutaneous gas
CT: when is this helpful?

10. Labs

Blood cultures – if given the option, are they helpful?
Wound cultures – any role for these?
Routine labs (CBC, BMP, etc) – are they helpful?
LRINEC score – what is it and should we be using it?

11. Treatment

NSTI antibiotics
Abscesses

12. Special populations

IV drug users
Diabetic patients
Immunocompromised patients

13. Wound irrigation and loop drainage

14. Disposition

Episode 69 – Cellulitis and Other Skin and Soft Tissue Infections

EMplify by EB Medicine

Episode 69 – Cellulitis and Other Skin and Soft Tissue Infections